Angina

Topic Contents

Topic Contents

Angina

Topic Overview

What is angina?

Angina (say "ANN-juh-nuh" or "ann-JY-nuh") is a symptom of heart disease. Angina happens
when there is not enough blood flow to the heart muscle. This is often a result of
narrowed blood vessels, usually caused by hardening of the arteries (atherosclerosis).

Angina can be dangerous. So it is important to pay attention to your symptoms, know
what is typical for you, learn how to control it, and understand when you need to
get treatment.

What are the symptoms?

Symptoms of angina include chest pain or pressure, or a strange feeling in the chest.
Some people feel pain, pressure, or a strange feeling in the back, neck, jaw, or upper
belly, or in one or both shoulders or arms. Other symptoms of angina include shortness
of breath, nausea or vomiting, lightheadedness or sudden weakness, or a fast or irregular
heartbeat.

Some people describe their angina as pressure, heaviness, weight, tightness, squeezing,
discomfort, burning, or dull aching in the chest. People often put a fist to the chest
when describing their pain. Some people may feel tingling or numbness in the arm,
hand, or jaw when they have angina.

It might be hard for you to point to the exact location of your pain. Pressing on
the chest wall does not cause the pain.

Your symptoms might begin at a low level and then increase over several minutes to
reach a peak. Angina that starts with an activity usually will decrease when the activity
is stopped. Chest pain that begins suddenly or lasts only a few seconds is less likely
to be angina.

Do not wait if you think you are having a heart attack. Getting help fast can save
your life. Even if you're not sure it's a heart attack, have it checked out.

What are the types of angina?

Stable angina

Stable angina means that you can usually predict when your symptoms will happen. You
probably know what things cause your angina. For example, you know how much activity
usually causes your angina.

Angina symptoms happen when your heart is working harder and needs more oxygen than
can be delivered through the narrowed arteries. Angina may happen when you are:

Doing strenuous exercise (especially if you typically do not exercise).

Being exposed to cold temperatures.

Having sudden, intense emotions, such as anger or fear.

Smoking.

Eating a heavy meal.

Using cocaine or amphetamines.

The pain goes away when you rest or take nitroglycerin. It may continue without much
change for years.

Unstable angina

Unstable angina is unexpected. It is a change in your usual pattern of stable angina.
It happens when blood flow to the heart is suddenly slowed by narrowed vessels or
small blood clots that form in the coronary arteries. Unstable angina symptoms are
like heart attack symptoms. It is an emergency. It may happen at rest or with light
activity. It does not go away with rest or nitroglycerin.

Angina caused by coronary artery spasms

Less common types of angina are caused by coronary artery spasms. This angina happens
when a coronary artery suddenly contracts (spasms), reducing oxygen-rich blood flow
to the heart muscle. If severe, a spasm can block blood flow and cause a heart attack.
Most people who have these spasms have coronary artery disease, though they don't
always have plaque that narrows their arteries.

The spasms can be caused by smoking, cocaine use, cold weather, an electrolyte imbalance,
and other things. But in many cases, it isn't known what triggers the spasms.

Vasospastic angina, also called Prinzmetal's angina or variant angina, is one type of angina that is
caused by coronary artery spasm. It has a distinctive pattern. It usually occurs when
you're resting. It often happens at the same time each day. For example, it often
happens at night or in the early morning. Symptoms are typically mild at first, then
get worse, and then get less intense. An episode may last about 15 minutes. Nitroglycerin
can relieve symptoms.

How do you manage stable angina?

Most people who have stable angina can control their symptoms by taking medicines
as prescribed and nitroglycerin when needed.

What makes symptoms worse?

Other health problems, such as fever or infection, anemia, or other heart problems,
can make your angina symptoms worse. They may also cause unstable angina.

Angina may get worse when another condition:

Forces your heart to work harder, which increases the amount of oxygen it needs.

Decreases the amount of oxygen the heart receives.

In either case, there is an imbalance between the amount of oxygen that your heart
needs and the amount that it receives through the blood supply from your coronary
arteries. If your heart can't get enough oxygen, your symptoms of stable angina may
get worse.

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